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In the year 2014, Ministry of Health introduced a new National Health Insurance that carried out a more complex administrative work, including to those of patient with hemophilia (PWH).

We aim to evaluate respond time in providing clotting factor to the PWH in the Manado Hemophilia Treatment Center, RD Kandou Hospital.

We performed a retrospective study from January to December 2014. Data collected from every visit of PWH with bleeding to our center. We collected data of time of arrival in triage and time of clottingfactor injection.

Respon time in providing clotting factor to

patient with hemophilia in Manado

Stefanus Gunawan, David Waworuntu, Max Mantik

Department of Child Health Faculty of Medicine Sam Ratulangi University

Prof. Dr. R. D. Kandou Hospital Manado

INTRODUCTION

RESULTS

OBJECTIVE

From 192 cases, 59 cases were excluded due to incomplete data. Out of 133 cases, 47 cases were injected in < 2 hours after arrival (mean 66 minutes, 95% CI 57 – 77 minutes) 86 cases were injected > 2 hours after arrival (mean 4.6 hours, 95% CI 4.2 – 5.3 hours). Most of the bleeding were joint and/or muscle bleeding; one case was a fatal intra abdominal bleeding and none of the case was intracranial bleeding.

Respond time in providing clotting factor to PWH in the era of new National Health Insurance is unsatisfactory. Efforts should be made to shorten the respond time and simplify the administrative works.

1. Shima M, Matsumoto T, Fukuda K, Kubota Y, Tanaka I, et al. The utility of actived partial thromboplastin time (aPTT) clot waveform analysis in the investigation of hemophilia A patients with very low levels of factor VIII activity. Thromb Haemost 2002: 87: 436-41

2. Farrugia A. Guide for the assessment of clotting factor concentrates, 2nd ed. Montreal: World Federation of Hemophilia, 2008.3. Brooker M. Registry of Clotting Factor Concentrates, 9th edition. Facts and Figures monograph no 6. Montreal: World Federation of Hemophilia, 2012.

METHODS

CONCLUSION

REFERENCES

< 2 hours (47 case)> 2 hours (86 case)

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Figure 1. Time of clotting factor injection

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